SIOUX FALLS, Iowa—Deb Fegenbush was praying she would win the lottery. The odds were one in 292 million, but the jackpot was $92 million, more than enough to keep the Planned Parenthood clinic she manages in the Morningside neighborhood open.

“I’m never lucky, but I did buy a Powerball ticket today,” Fegenbush said from behind her desk in a small makeshift office when I visited last month, on the last day the clinic would see patients before closing for good on June 30. “If I won the lottery, I could continue to help Planned Parenthood.”

Sioux City is one of four Planned Parenthood clinics in Iowa that are shutting down after Gov. Terry Branstad signed a bill in May to “defund” the healthcare organization. Dozens of states have introduced similar measures targeting Planned Parenthood in the past couple of years, and a few, like Texas and Missouri, have succeeded. Kicking Planned Parenthood off Medicaid and “defunding” the organization has repeatedly come up in Congress as well. As the Senate lurches toward a vote on repealing the Affordable Care Act, the fight to strip Planned Parenthood of public money remains one of the most divisive.

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